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输入血小板计数与当前药物的相互作用以及慢性皮肤下皮肤复发的风险

Shawn R Eagle¹, Aditya M Mittal¹, Ryan T Kellogg²

¹1Department of Neurological Surgery, University of Pittsburgh, Pennsylvania.

Neurosurgical focus

|October 1, 2023

概括

手术后复发的慢性下皮血瘤 (cSDH) 可以通过入院血小板计数,术前使用他类药物和抗凝剂使用来预测. 识别这些风险因素可以帮助管理cSDH复发.

科学领域:

神经外科神经外科
数据科学数据科学数据科学
医疗信息学医疗信息学

背景情况:

慢性下皮质血瘤 (cSDH) 是一个重大挑战,在手术后的复发率为10% - 24%.
现有的cSDH复发的预后模型已经产生了不一致的结果.

研究的目的:

利用千方形自动交互检测 (CHAID) 数据挖掘算法来识别cSDH重复手术的强大预测因素.
将连续,名义和二进制数据纳入决策树,以提高预测准确度.

主要方法:

在两个1级创伤中心,对435名接受cSDH疏散的患者进行了回顾性队列研究.
应用CHAID来确定预测因素,包括年龄,性别,并发症,并发症,血小板计数,中线转移,血瘤体积和药物使用 (抗凝血剂,抗血小板剂,他类药物).

主要成果:

观察到复发率为13.8% (60/435名患者).
入院血小板计数是cSDH复发的最强预测因素,确定了特定的切断点 (<157 × 10^9/L和≤179 × 10^9/L).
手术前使用他类药物和使用抗凝剂也是显著的预测因素,风险增加因患者子组而异.

结论:

在CHAID模型准确预测cSDH复发 (87.4%准确率,AUC 0.76).
入院血小板计数,手术前使用他类药物和使用抗凝剂是重复cSDH手术的关键预测因素.
建议进行进一步的研究,以探索已识别的血小板计数切线的可变性及其与潜在疾病的关系.

关键词:

抗凝固剂是一种抗凝固剂.慢性皮下血液瘤慢性皮下血液瘤血小板计数血小板计数血小板计数血小板计数复发性复发性复发性类药物类药物类药物

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